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General NPI Number Information
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NPI Number | 1770644825
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Entity Type | Organization
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Legal Business Name | VISION PLUS LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1955 E. MAIN ST SUITE C
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City | DUNCAN
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State | SC
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Zip | 29334-9214
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Country | US
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Telephone | 864-433-9555
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Fax | 864-433-9523
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Provider Business Mailing Address
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Address Line | 1955 E. MAIN ST SUITE C
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City | DUNCAN
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State | SC
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Zip | 29334-9214
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Country | US
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Telephone | 864-433-9555
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Fax | 864-433-9523
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Authorized Official
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Title or Position | OPTOMETRRIST
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Name | DR. CRAIG BERNARD PRUITT
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Credential | OD
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Telephone | 864-433-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1064
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License Number State | SC
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